title: Lung cancer and renal insufficiency: prevalence and anticancer drug issues.
abstract: The Renal Insufficiency and Anticancer Medications (IRMA) study reported the high prevalence of renal insufficiency in cancer patients. In this special report, we focused on patients with lung cancer, emphasizing some specific findings in this population of patients. Data on patients with lung cancer who were in the IRMA study were analyzed. Renal function was calculated using Cockcroft-Gault and abbreviated Modification of Diet in Renal Disease (aMDRD) formulas to estimate the prevalence of renal insufficiency (RI) according to the KDOQI-KDIGO definition. Anticancer drugs were studied with regard to their potential renal toxicity and need for dosage adjustment. Of the 445 IRMA lung cancer patients, 14.4% had a serum creatinine (SCR) level > or =110 micromol/L. However, when they were assessed using the formulas, 62.1 and 55.9% had abnormal renal function. Of the 644 anticancer drug prescriptions, 67.5% required dose adjustments for RI or were drugs with no available data, and 78.3% of the patients received at least one such drug. Furthermore, 71.6% received potentially nephrotoxic drugs. Seventy percent of the patients had anemia but prevalence was not significantly associated with the existence of associated renal insufficiency. In the 445 IRMA patients with lung cancer, the prevalence of RI was high in spite of a normal SCR in most cases. Some anticancer drugs such as platinum salts may be nephrotoxic and need dosage adjustment. However, other important drugs such as gemcitabine do not require dose reduction and do not present with a high potential for nephrotoxicity. Lung cancer patients often present with anemia, which was not associated with the presence of RI.
authors.affiliation: Department of Nephrology, Pr. Deray, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France. vincent.launay-vacher@psl.aphp.fr
authors.forename: Vincent
authors.initials: V
authors.lastname: Launay-Vacher
authors.forename: Reza
authors.initials: R
authors.lastname: Etessami
authors.forename: Nicolas
authors.initials: N
authors.lastname: Janus
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Spano
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ray-Coquard
authors.forename: Stéphane
authors.initials: S
authors.lastname: Oudard
authors.forename: Joseph
authors.initials: J
authors.lastname: Gligorov
authors.forename: Xavier
authors.initials: X
authors.lastname: Pourrat
authors.forename: Philippe
authors.initials: P
authors.lastname: Beuzeboc
authors.forename: Gilbert
authors.initials: G
authors.lastname: Deray
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Morere
mesh_terms: D000740:Anemia / Q000453:epidemiology; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D005602:France / Q000453:epidemiology; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015995:Prevalence; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D003404:Creatinine; D000093542:Gemcitabine